| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $342.28 | $342.28 | $342.28 | |
Midlands
| Facility | $87.34 | $87.34 | $87.34 | |
Midlands
| Professional | $87.34 | $87.34 | $87.34 |
Cont Rec Mvmt Do Sx 6 D<10 D 1st Reprt Cnfig
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Professional | $342.28 | $342.28 | $342.28 | |
Midlands
| Facility | $87.34 | $87.34 | $87.34 | |
Midlands
| Professional | $87.34 | $87.34 | $87.34 |